New Survey Shows Americans Overwhelmingly Believe Congress and the Biden Administration Should Crack Down on Medicare Advantage Insurers for Abusive Billing Practices
WASHINGTON, D.C. — A new national survey shows voters overwhelmingly support the Centers for Medicare and Medicaid Services’ (CMS) proposed reforms that would better protect taxpayers and seniors from abusive overbilling by Medicare Advantage (MA) insurance companies.
The survey shows nearly 9 in 10 voters (87%) favor reforms to reduce Medicare Advantage overpayments. This includes (90%) of Democrats, (85%) of independents, and (86%) of Republicans.
The survey shows most voters (65%) worry about insurance companies overcharging Medicare, and strong majorities say that the government should do more to protect Medicare Advantage from insurers:
— 70% say the government should do more to prevent fraudulent billing practices by health insurance companies in Medicare Advantage
— 65% say the government should do more to hold health insurance companies in Medicare Advantage accountable for providing value to beneficiaries and taxpayers
— 64% say the government should do more to make sure health insurance companies in Medicare Advantage are not overpaid for the coverage they provide
“It’s not often we find such broad agreement with a proposed policy change. Voters support reforms to prevent insurance companies from overbilling Medicare Advantage by an overwhelming 87% to 4% margin,” said Guy Molyneux, a partner with Hart Research Associates. “Surprisingly, voters on Medicare — who are often skeptical of changes to the program — favor reform by the same lopsided 87% to 4% margin as the general public.”
“What’s striking about voter support for these changes is the consensus across political lines. Nearly as many Republicans (86%) and independents (85%) support the proposal as Democrats (90%),” added Bob Ward, a partner at Fabrizio Ward. “This is also true for both Biden voters (89%) and Trump voters (87%).”
In February, CMS proposed technical changes to the way the Medicare program determines payments to Medicare Advantage plans. This comes after multiple federal lawsuits, audits, and investigations determined that many big insurance companies have systematically overcharged seniors and taxpayers billions of dollars each year.
“The plans are spending millions to say they aren’t being paid enough, although analyses by MedPAC, KFF, and the industry’s own statements suggest they have comfortable profit margins,” said Mark Miller. “This notice is only a small step to improve accountability and oversight to better serve the aged, disabled, and taxpayers. More needs to be done to correct the full extent of the fraudulent and abusive billing practices.”
One tactic insurance companies use to charge seniors and taxpayers more than they owe is called upcoding. Every unwarranted code increases payments to plans often without helping patients. MedPAC, an independent Medicare commission created to advise Congress, noted in its March report that uncorrected Medicare Advantage coding intensity is projected to generate nearly $44 billion in payments by the federal government to plans in 2022 and 2023. MedPAC estimates the abusive billing practices will cost taxpayers $23 billion in 2023 alone. CMS’ proposed changes would revise the risk adjustment model to make it less prone to upcoding by insurance companies.
The survey included a sample of 1,001 registered voters nationwide and was conducted March 14 – 16 by Hart Research Associates and Fabrizio Ward. The survey was funded by Arnold Ventures.
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